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Crc Risk Adjustment Coder Jobs in Claymont, DE (NOW HIRING)

AIG

Senior Underwriting Assistant

Philadelphia, PA · On-site

$60K - $68K/yr

This role assists the underwriters by screening risk offerings and with pre and post-binding ... Performs quality control of adjustments prior to underwriting review; documents discrepancies and ...

AIG

Senior Underwriting Assistant

Philadelphia, PA · On-site

$60K - $68K/yr

This role assists the underwriters by screening risk offerings and with pre and post-binding ... Performs quality control of adjustments prior to underwriting review; documents discrepancies and ...

Vangard, Inc.

Cloud Security Engineering Manager

Malvern, PA · On-site

$64.25 - $85.25/hr

... or risk-rating adjustment of cloud security findings * Shape remediation SLAs, build-breaking ... Experience with Claude Code/Codex or Threat Modeling * Demonstrated passion for continuous learning

Matthey

Facilities Engineer

West Deptford, NJ · On-site

$103 - $115/hr

Comply with all applicable codes, regulations, governmental agency and Company directives related ... Able to balance risk and cost, and experience of risk management* Must have a can-do mindset and ...

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All JobsCrc Risk Adjustment Coder JobsCrc Risk Adjustment Coder Jobs in Claymont, DE

Crc Risk Adjustment Coder information

See Claymont, DE salary details

$15

$26

$42

How much do crc risk adjustment coder jobs pay per hour?

As of Aug 19, 2026, the average hourly pay for crc risk adjustment coder in Claymont, DE is $26.82, according to ZipRecruiter salary data. Most workers in this role earn between $18.51 and $33.75 per hour, depending on experience, location, and employer.

What is the difference between Crc Risk Adjustment Coder vs Medical Coder?

AspectCrc Risk Adjustment CoderMedical Coder
CertificationsCPMA, CPC, or RHIT/RHIA often preferredCPC, CCS, or CPC-H
Work EnvironmentHealthcare facilities, insurance companies, risk adjustment teamsHospitals, clinics, physician offices
Industry UsageRisk adjustment, Medicare Advantage, health plansMedical billing, coding, documentation

The Crc Risk Adjustment Coder specializes in coding for risk adjustment programs, focusing on accurate documentation for insurance and Medicare plans. Medical Coders handle a broader range of medical records and billing tasks across various healthcare settings. While both roles require coding certifications, Crc Risk Adjustment Coders focus more on risk and reimbursement accuracy within insurance programs.

What are popular job titles related to Crc Risk Adjustment Coder jobs in Claymont, DE?

For Crc Risk Adjustment Coder jobs in Claymont, DE, the most frequently searched job titles are:

What job categories do people searching Crc Risk Adjustment Coder jobs in Claymont, DE look for?

The top searched job categories for Crc Risk Adjustment Coder jobs in Claymont, DE are:

Crc Risk Adjustment Coder jobs near you

Certified Professional Coder

Regional Medical Management Services LLC

Wilmington, DE • On-site

$22 - $28/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 17 days ago

Job description

  • Position Summary

    • The Certified Orthopedic Coder is responsible for accurately assigning ICD-10-CM, CPT, and HCPCS Level II codes for orthopedic-related diagnoses, procedures, and services. This role requires deep knowledge of musculoskeletal anatomy, surgical techniques, and orthopedic subspecialties to ensure compliant coding, optimal reimbursement, and adherence to payer and regulatory guidelines. The coder works closely with physicians, clinical staff, and billing teams to support clean claims, audit readiness, and revenue integrity.

  • Key Responsibilities
  • Coding & Documentation
  • Assign accurate ICD10CM, CPT, and HCPCS codes for orthopedic outpatient, inpatient, and surgical services
  • Code complex orthopedic procedures including:

    • ~Joint replacements

    ~Arthroscopy

    ~Spine procedures

    ~Fracture care

    ~Sports medicine procedures

  • Ensure coding reflects correct laterality, encounter type, global periods, and modifiers (e.g., 26, TC, 50, 59, LT/RT)
  • Compliance & Quality
  • Maintain compliance with CMS, AMA, payerspecific, and regulatory coding guidelines
  • Participate in internal and external audits; address findings and implement corrective actions
  • Stay current with annual coding updates, NCCI edits, LCDs/NCDs, and orthopedic coding trends
  • Identify documentation gaps and proactively query providers when clarification is needed
  • Collaboration & Support
  • Work closely with orthopedic surgeons, APPs, and clinical teams to improve documentation quality
  • Support billing and denial management teams by providing coding clarification and appeal support
  • Contribute to process improvement initiatives focused on accuracy, efficiency, and compliance
  • Productivity & Reporting
  • Meet or exceed established productivity and accuracy benchmarks
  • Track and report coding issues, trends, and opportunities for improvement
  • Assist with onboarding and mentoring junior coders as needed
  • Required Qualifications
  • Education & Certification

    • ~High school diploma or equivalent required

    ~Active coding certification, such as:

    CPC (AAPC)

    CCS (AHIMA)

    ~Orthopedic coding specialty certification preferred (e.g., COSC)

  • Experience

    • ~Minimum 2–3 years of orthopedic-specific coding experience

    ~Demonstrated experience coding operative reports and complex orthopedic cases

    ~Experience with EHR and practice management systems

  • Preferred Qualifications

    • ~Experience in high-volume orthopedic or multispecialty practices

    ~Knowledge of both professional and facility coding

    ~Prior audit or compliance experience

    ~Familiarity with value-based care and risk adjustment principles

  • Skills & Competencies

    • ~Advanced knowledge of musculoskeletal anatomy and orthopedic procedures

    ~Strong attention to detail with high accuracy standards

    ~Analytical mindset with the ability to interpret complex clinical documentation

    ~Excellent written and verbal communication skills

    ~Ability to work independently while collaborating across departments

    ~Strong time management and organizational skills

  • Work Environment
  • Officebased
  • Prolonged periods of computerbased work
  • Fastpaced, deadlinedriven environment requiring sustained accuracy
  • Performance Metrics
  • Coding accuracy rate
  • Productivity benchmarks
  • Audit outcomes
  • Denial reduction and clean claim rates
  • Benefits
  • 401(k)
  • 401(k) matching
  • Dental insurance
  • Dependent care flexible spending account
  • Health insurance
  • Life insurance
  • Paid time off
  • Vision insurance

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